Takahashi Tohru, Tsukuda Hiroyuki, Kimura Hirokazu, Yoshimoto Mitsuru, Tsujisaki Masayuki
Department of Hematology and Gastroenterology, Tenshi Hospital, Sapporo.
Intern Med. 2010;49(5):447-51. doi: 10.2169/internalmedicine.49.2904. Epub 2010 Mar 1.
This report describes a patient with extramedullary relapse of acute myeloid leukemia (AML) without involving bone marrow. A 57-year-old man was diagnosed as having acute monoblastic leukemia with t(9;11)(p22;q23) and trisomy 8. Ten months after achieving complete response (CR) with chemotherapy, masses developed in his left forearm and in the back of his thigh, preceded by enigmatic peripheral neurological symptoms. Aspiration from the forearm showed leukemic relapse, and fluorescence in situ hybridization (FISH) revealed that the majority of the cells had 11q23 anomaly and tetrasomy 8. Bone marrow or meningeal relapse was not observed. To our knowledge, this is the first case report of clonal evolution associated with the development of myeloid sarcoma as a relapse in AML.
本报告描述了一名急性髓系白血病（AML）髓外复发且未累及骨髓的患者。一名57岁男性被诊断为急性单核细胞白血病伴t(9;11)(p22;q23)和8号染色体三体。化疗达到完全缓解（CR）10个月后，他的左前臂和大腿后部出现肿块，之前有难以解释的周围神经症状。前臂穿刺显示白血病复发，荧光原位杂交（FISH）显示大多数细胞有11q23异常和8号染色体四体。未观察到骨髓或脑膜复发。据我们所知，这是首例与髓系肉瘤发展相关的克隆进化作为AML复发的病例报告。
